27 April, 2006

ob-gyn please

As I watched TV while getting ready for work, it said that there is a huge shortage in obstetricians and gynecologists (ob-gyn) in Japan. It said the problem is especially severe in the suburbs and the rural regions. An increasing number of maternity clinics are forced to close down or cannot give emergency surgeries/ cannot respond to emergent cases due to the lack of doctors.
Some local administrations are even trying to recruit ob-gyns with an unbelievably high salary (53 million yen = approx.USD460,000) but still they can't find anyone raising his/her hand, and some other administrations have to invite ob-gyns from abroad to see the local residents/mothers.

It doesn't naturally mean though, that doctors in general are running short. In fact, the number of doctors in Japan is increasing. However, only the ob-gyns are showing remarkable decrease.
In contrast to the aging of the present ob-gyns in Japan --- more than 40% of them are older than 60 years of age --- new doctors hoping to become ob-gyns have decreased to the point of only 3-4% of the total of those who pass the national exam for medical practitioners.

What's behind all this?
The TV show pointed out three reasons.

1) The frequency of duty: it is said that ob-gyn doctors have to be on duty more than twice as much as doctors of other departments. Makes me feel the fragility of tiny lives...

2) The number of medical lawsuits: because giving birth is a happy occassion unlike injuries or illness, failure in child delivery is considered to cause much more shock. Well... true, I guess. But then, ob-gyn doctors are given mental stress on top of physical fatigue. Poor thing... s/he'll be worn out.

3) Last but not least, the increase in high-risk pregnancy & delivery and the lack of hospitals' ability to respond to emergency: due to increase of the demand and supply of female labor force, more and more women marry late and become pregnant at an older age than before. For this reason and also because of fertility treatment in other cases, pregnancy has gotten riskier. But on the other hand not many hospitals are actually ready to take care of such pregnancy and thus the burden of each doctor is becoming heavier.

Each reason is pretty heavy and I can understand that not many want to become ob-gyn doctors...

You know, in a country which the birthrate is dropping one-way, isn't it critical that there aren't many hospitals that are ready to welcome those precious ones who want to give birth to their babies? Makes me feel like the future of this country is collapsing silently.

Several decades ago, like in my parents' or more like my grandparents' generation there use be a lot of midwives called samba-san. Samba-san didn't only deliver the baby, but took care of the mother while pregnancy, from food, daily care, massage, councelling and all that. They supported the mother physically and mentally.

The Japanese ob-gyn association looking ahead of the situation announced on 22nd a plan to secure maternity clinics that can respond to the described situations.

But as far as what I can see from the plan, there doesn't seem to be a concrete plan to increase the number of doctors.
Hey, I think that samba-san can save the future of Japan. Why don't the clinics and samba-san tie up and work together? Why don't the samba-san deliver babies with low birth risk while doctors take care of the more serious cases?

A pretty difficult and heavy matter, huh? But I think people have to face the reality so I decided to choose it as the topic of today's blog. Any revolutionary suggestions out there?

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